title: Depression, healthcare utilization, and comorbid psychiatric disorders after spinal cord injury.
abstract: BACKGROUND
  Depression is often comorbid with other psychiatric conditions in the general population, with resultant impact on severity of conditions and healthcare utilization. It is unclear to what degree this is also true among persons with spinal cord injury (SCI).
  
  
  OBJECTIVE
  This study examined rates at which psychiatric conditions were comorbid with depression after SCI, and the association between a depression diagnosis and healthcare and pharmaceutical drug use.
  
  
  METHODS
  Retrospective analysis of data (N = 41 213) abstracted from Veterans Health Administration administrative databases between fiscal years (FYs) 1997 and 2007 to examine overall rates of depression. Administrative data from FY 2007 was used to examine rates of psychiatric disorders comorbid with depression, and to compare veterans with SCI and depression to veterans with SCI but no depression on healthcare and pharmaceutical use.
  
  
  RESULTS
  Twenty-eight percent (n = 11 506) of 41 213 veterans who received SCI care between FY 1997 and FY 2007 were diagnosed with depressive disorders. Among the veterans with SCI and depression diagnoses in 2007 (n = 2615), 70% were also diagnosed with another psychiatric illness, with posttraumatic stress disorder and other anxiety disorders being the most common. Veterans with SCI and depression had more healthcare visits and received more pharmaceutical prescriptions than their counterparts without depression.
  
  
  CONCLUSIONS
  Persons with SCI and depression are likely to experience comorbid psychiatric illnesses, with associated increased healthcare visits and medication use. Research and theory on depression after SCI should develop toward describing and addressing psychiatric and medical co-morbidities that are normative in this population.
authors.forename: Philip M
authors.initials: PM
authors.lastname: Ullrich
authors.forename: Bridget M
authors.initials: BM
authors.lastname: Smith
authors.forename: Frederic C
authors.initials: FC
authors.lastname: Blow
authors.forename: Marcia
authors.initials: M
authors.lastname: Valenstein
authors.forename: Frances M
authors.initials: FM
authors.lastname: Weaver
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015897:Comorbidity; D003695:Delivery of Health Care / Q000379:methods / Q000706:statistics & numerical data*; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology*; D008875:Middle Aged; D013119:Spinal Cord Injuries / Q000453:epidemiology* / Q000628:therapy*; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000523:psychology; D055815:Young Adult
keywords: Comorbidity; Depression; Healthcare; Posttraumatic stress disorder; Spinal cord injury